Fertility Medication Comparison: What Works, What Doesn't, and Why

When you're trying to get pregnant and things aren't happening, fertility medication, prescription drugs designed to trigger or regulate ovulation. Also known as ovulation inducers, these medications aren't magic—they're tools that work only if your body has the right foundation. The biggest mistake people make is assuming one pill fixes everything. It doesn't. Clomid and Letrozole are the two most common options, but they work differently, have different side effects, and suit different bodies.

Clomid, a selective estrogen receptor modulator that tricks the brain into producing more follicle-stimulating hormone. Also known as clomiphene citrate, it's been around for decades and is often the first try. It works for women with irregular cycles or PCOS, but it can thin the uterine lining and lower cervical mucus—two things that make it harder for sperm to reach the egg. Letrozole, an aromatase inhibitor originally used for breast cancer that now leads as a first-line fertility drug in many clinics. Also known as Femara, it doesn't mess with cervical mucus or the uterine lining like Clomid does, and studies show it leads to higher live birth rates in women with PCOS. Then there's gonadotropins—injectables like Follistim or Gonal-F. They're stronger, faster, and way more expensive. They're not for everyone, but when oral meds fail, they're often the next step.

Stress doesn't just make you tired—it messes with your hormones and can stop ovulation cold. That's why some people see results after switching meds, but others don't. It's not always the drug. It's the whole picture: weight, sleep, thyroid levels, insulin resistance. If you've tried Clomid and nothing happened, don't assume you're broken. Try Letrozole. If that doesn't work, check your thyroid. If your AMH is low, maybe you need a different approach entirely. Fertility meds aren't one-size-fits-all. What works for your friend might do nothing for you, and that's normal.

Below, you'll find real comparisons between these drugs and others—side effects, costs, success rates, and what doctors actually recommend when the first option fails. No fluff. No hype. Just what you need to know to talk to your doctor with confidence.